| Renew Pc | |
|
30230 Rancho Viejo Rd Ste 134 San Juan Capistrano CA 92675-1585 | |
| (949) 478-1411 | |
| Not Available |
| Full Name | Renew Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Pain Medicine |
| Location | 30230 Rancho Viejo Rd Ste 134, San Juan Capistrano, California |
| Authorized Official Name and Position | Tanya Dall (OWNER) |
| Authorized Official Contact | 9497026736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Pc 146 Spur St Rancho Mission Viejo CA 92694-1614 Ph: (949) 702-6736 | Renew Pc 30230 Rancho Viejo Rd Ste 134 San Juan Capistrano CA 92675-1585 Ph: (949) 478-1411 |
| NPI Number | 1386353126 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386353126 | NPI | - | NPPES |
| 1235592478 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P2900X | Psychiatry & Neurology - Pain Medicine | (* (Not Available)) | Primary |
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